government ehr funding: meaningful use stage 2 update october 25, 2012 jonathan krasner healthcare...
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GOVERNMENT EHR FUNDING: MEANINGFUL USE STAGE 2
UPDATE
October 25, 2012
Jonathan KrasnerHealthcare IT [email protected]
CMS Ruling August 2012
• Final ruling issued by CMS on 8/23/12
• Most changes effective in 2014
• Some changes effective in 2013
• Changes to Stage 1 and introduces Stage 2
• Stage 1 was about collecting data
• Stage 2 is all about data communication!
• Also effects EHR Certification
www.beinetworks.com
Meaningful Use Timeline – Adoption Stages
Meaningful Use – Payment Stages(Medicare)
Changes to Stage 1: CPOE
Current Measure: More than 30 percent of all unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE.
Changes to Stage 1: Vital Signs
The vital signs changes are optional in 2013, but required starting in 2014
Changes to Stage 1: Exchange of Data
Current Measure: Perform at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.
Changes to Stage 1: E-Copy / Online Access
Tip: The practice must make healthcare information (e.g. outside lab results) available to patients via patient portal within 4 days of when it is
available to the practice. You will have to implement patient portal if you have not already done so.
Changes from Stage 1 to Stage 2
Changes to Meaningful Use - 2014
Menu Objective Exclusion While you can continue to claim exclusions, if applicable, to menu objectives, starting in 2014 these exclusions will no longer count towards the number of menu objectives.
Changes to Meaningful Use 2014
Reporting Period Reduced to Three MonthsTo allow providers time to adopt 2014 certified EHR technology and prepare for Stage 2, all participants will have a three-month reporting period in 2014. However, the reporting period must be a calendar quarter
Clinical Quality Measure (CQM) Changes
Although reporting CQMs is no longer a core objective, all providers are required to report on CQMs in order to demonstrate Meaningful Use
In 2014 and beyond, reporting programs (PQRS, eRx, MU) will be streamlined and aligned in order to reduce provider burden
CQM Changes
All providers must complete 9 out of 64 CQMs
The CQMs for 2014 will be different than what we have today, and will be published on the CMS website
CQMs must be selected out of 3 of 6 National Quality Strategy domains
CQMs will be reported electronically, directly from the EHR
This area is very complex and will require your attention!
CQM Domains
Stage 2: Batch Reporting
Starting in 2014, groups will be allowed to submit attestation information for all of their individual EPs in one file for upload to the Attestation System, rather than having each EP individually enter data.
Stage 2: EHR Certification
Your EHR will have to be certified for Stage 2. You cannot use the current version of your EHR software to attest in Stage 2.
Stage 1: Core Measures
1. Use CPOE for medication orders (30% of patients)
2. Implement drug-drug and drug-allergy interaction checks
3. Maintain an up-to-date problem list (80% of patients)
4. Generate and transmit e-prescriptions (40% of patients)
5. Maintain active medication list (80% of patients)
6. Maintain active medication allergy list (80% of patients)
7. Record demographics (50% of patients)
8. Record vital signs (50% of patients)
9. Record smoking status (50% of patients)
10. Report CQMs
Stage 1: Core Measures (cont’d)
11. Implement one clinical decision support rule
12. Provide patients with an electronic copy of health information (50% of patients)
13. Provide clinical summaries for each visit (50% of patients)
14. Exchange key clinical information
15. Conduct a HIPAA Security Analysis
Stage 2: Core Objectives
Was 40%
Was 30% med
Was 50%
Was 50%
Was 40% Menu
Stage 2: Core Measures
Stage 1: Menu Measures
1. Implement drug formulary checks2. Incorporate clinical lab-test results as structured data (40% of labs)3. Generate a list of patients by condition4. Send patient reminders for follow-up care (20% of patients)5. Provide patients with timely electronic access to health information (10%
of patients)6. Provide patient specific education resources (10% of patients)7. Perform medication reconciliation when receiving a patient from another
setting of care (50% of patients)8. Provide a summary care record for transitions to another setting of care
(50% of patients)9. Capability to submit data to immunization registries10.Capability to submit electronic syndromic surveillance data
Stage 2: Menu Measures
Summary
We’ve been here before, so this is not all new
Lots of changes between Stage 1 and Stage 2
Start familiarizing yourself with the changes
Start talking to your staff and physicians
Plan your EHR upgrade
Develop a transition plan
You will get through it!